Acts as a medical resource to the health plan, directing clinical and government mandated utilization and quality improvement efforts. Responsible for the consistent, effective use of clinical guidelines and clinical nursing rounds. Monitors quality and the appropriateness of medical care. Collaboration on clinical program development in concert with the operational leadership of the plan.
Minimum of 5 years of clinical experience
Managed Care Experience
Board Certification in a General Practice, Internal Medicine, Primary Care or Geriatrics
Practical understanding and strong commitment to managed care
Knowledge of Quality Assurance, Utilization Review, program development and implementation skills
Strong communication and leadership skills
Benefits:
We truly value our staff and further acknowledge their contributions by offering:
Employee and family health coverage
Competitive salaries
Employer contributed pension plan
Generous time off
Tuition reimbursement
403(b) retirement plan
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